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Personal information
Name
First name Last name
OCCUPATION*
Telephone*
E-mail*
Date of birth*
DD slash MM slash YYYY
Address*
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Requested training
Formation demandée*
Your expectations regarding this training session
Your expectations*
Additional information
Do you have a disability?*
What would be the adaptations you would need to follow the training in the best conditions?
Additional information you wish to share with us or specific needs for your training
Payment method
Moyen de paiement*
400€
Acompte*
Carte bancaire*
Card details
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Billing address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Please send us a transfer of €400,
bank details available here.
Please send us a bank check of €400 to:
In Cognita,
9 rue du Jeu de Paume,
78640 Neauphle le Château
RGPD*
By ticking this box, I confirm that I have read, understood and accept the general terms & conditions*